Spina Bifida and Scoliosis Inquiry Risks 'Farcical Exercise' Without Proper Powers, Advocates Warn
Advocates for children affected by spina bifida and scoliosis have warned that a proposed commission of investigation into concerns about their care at Children's Health Ireland risks becoming a "farcical exercise" unless it is properly resourced and given sufficient powers to compel witnesses and access records. The warning comes as the review of care at CHI remains incomplete three years after concerns were first raised, and as families continue to wait for answers about what went wrong with their children's treatment.
Background
The concerns about spinal surgery for children with spina bifida and scoliosis at Children's Health Ireland first came to light in 2023, when a number of families raised questions about the quality of care their children had received. The concerns centred on the outcomes of spinal fusion surgery — a complex and high-risk procedure — and on whether the children had been adequately informed of the risks before consenting to treatment.
The HSE commissioned an independent review of the cases, but three years later that review remains incomplete. Families who have been waiting for answers about what happened to their children have expressed frustration and anger at the pace of the process, and several have spoken publicly about the devastating impact that the uncertainty has had on their lives. Some children have been left with significant disabilities as a result of their surgeries, and their families are seeking accountability and, where possible, redress.
The government has now proposed the establishment of a commission of investigation to examine the concerns, following the recommendation of the Oireachtas Health Committee. A commission of investigation has greater powers than an independent review — it can compel witnesses to give evidence and can access records that might otherwise be withheld — and advocates had initially welcomed the proposal as a positive step.
Key Developments
However, advocates have now raised concerns about the terms of reference and the resourcing of the proposed commission. They argue that without sufficient powers to compel witnesses and access records, the commission will be unable to get to the truth of what happened, and that without adequate resourcing it will take years to complete its work — by which time many of the children affected will have grown up without ever receiving a full explanation of what went wrong with their care.
The warning that the commission risks becoming a "farcical exercise" echoes concerns raised in the context of other Irish health inquiries, including the CervicalCheck scandal and the Symphysiotomy inquiry, where the pace and scope of investigations were criticised by those affected. Advocates have called on the Minister for Health to publish the terms of reference for the commission and to commit to a timeline for its completion.
Children's Health Ireland has stated that it is committed to cooperating fully with any investigation and that it has already implemented a number of changes to its spinal surgery programme in response to the concerns raised. However, families have questioned whether those changes are sufficient and whether the institution has been fully transparent about the extent of the problems.
Why It Matters
The spina bifida and scoliosis inquiry matters because it involves some of the most vulnerable children in the Irish healthcare system — children with complex medical needs who depend on the state to provide them with safe and effective care. The fact that concerns about their treatment were first raised three years ago and have still not been fully investigated is a serious failure of the healthcare system's accountability mechanisms.
The inquiry also matters because of its implications for the broader question of how Ireland investigates failures in its healthcare system. The pattern of slow, under-resourced inquiries that fail to deliver timely answers to those affected is a recurring feature of Irish healthcare governance, and the spina bifida and scoliosis case is the latest example of that pattern. The advocates' warning that the commission risks becoming a "farcical exercise" is a challenge to the government to demonstrate that it has learned from previous failures.
Local Impact
For the families of the children affected — many of whom are based in Dublin, Cork, and other major cities where Children's Health Ireland operates — the uncertainty about the commission's scope and timeline is a source of ongoing distress. These families have already waited three years for answers, and the prospect of a further lengthy inquiry process is deeply demoralising. Several families have indicated that they are considering legal action if the commission fails to deliver a comprehensive and timely account of what happened to their children.
What's Next
The Minister for Health is expected to publish the terms of reference for the commission of investigation in the coming weeks. Advocates have indicated that they will scrutinise the terms carefully and will make public their assessment of whether the commission has been given sufficient powers and resources to do its job effectively. The Oireachtas Health Committee has indicated that it will continue to monitor the situation and will hold the government to account if the commission's terms of reference are inadequate. The families affected have called for a meeting with the Minister before the terms of reference are finalised, to ensure that their concerns are taken into account.
